Daily blood pressure variability in relation to neurological functional outcomes after acute ischemic stroke

Zhu, Yuan; Wu, Minghua; Zheng, Yujun; Zhang, Siqi; Wang, Xintong; Wang, Shana; Fang, Zheng

doi:10.3389/fneur.2022.958166

Cited by 4 publications

(4 citation statements)

References 34 publications

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“…In patients with higher SBPV, we found that RIC significantly improved the functional outcomes compared with usual care alone, suggesting the significant effect of SBPV on RIC efficacy. Previous studies demonstrated that high SBPV was associated with poor functional outcome after acute ischemic stroke 11 , 16 . After acute moderate ischemic stroke, the cerebral autoregulation was impaired 17 .…”

Section: Discussionmentioning

confidence: 94%

“…In the current study, we found that higher SBPV was associated with more benefit from RIC treatment, while 2-week RIC treatment had no effect SBPV after acute ischemic stroke. SBPV was previously reported to be associated with poor outcome after acute ischemic stroke 11 , 16 . Considering the neutral effect of RIC treatment on SBPV and more benefit from RIC treatment in patients with higher SBPV, we inferred the efficacy of RIC treatment in stroke distinguished by SBPV may be attributed to the influence of SBPV on cerebral perfusion rather than the influence of RIC on SBPV.…”

Section: Discussionmentioning

confidence: 96%

“…Considering the neutral effect of RIC treatment on SBPV and more benefit from RIC treatment in patients with higher SBPV, we inferred the efficacy of RIC treatment in stroke distinguished by SBPV may be attributed to the influence of SBPV on cerebral perfusion rather than the influence of RIC on SBPV. However, in the current study, the SBPV was calculated only based on three times’ measurement, but not more extensive set of measurements, for example, measurements for 7 continuous days in the previous study 11 . The limited measurements may not more accurately reflect actual SBPV, which will affect the current findings.…”

Section: Discussionmentioning

confidence: 99%

“…The Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke (RICAMIS) trial demonstrated that RIC treatment initiated within 48 h of stroke onset safely and significantly improved excellent functional outcome at 90 days among patients with acute moderate ischemic stroke who did not receive any reperfusion therapy 9 . Systolic blood pressure variability (SBPV) was previously reported to be strongly associated with functional outcome after acute ischemic stroke 10 , 11 . An exploratory study demonstrated that 4-week RIC treatment may reduce blood pressure in partial hypertension patients 12 .…”

Section: Introductionmentioning

confidence: 99%

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Association of systolic blood pressure variability with remote ischemic conditioning in acute ischemic stroke

Cui,

Ning,

Cai

et al. 2024

Sci Rep

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Systolic blood pressure variability (SBPV) is associated with outcome in acute ischemic stroke. Remote ischemic conditioning (RIC) has been demonstrated to be effective in stroke and may affect blood pressure. Relationship between SBPV and RIC treatment after stroke warrants investigation. A total of 1707 patients from per-protocol analysis set of RICAMIS study were included. The SBPV was calculated based on blood pressure measured at admission, Day 7, and Day 12. (I) To investigate the effect of SBPV on efficacy of RIC in stroke, patients were divided into High and Low categories in each SBPV parameter. Primary outcome was excellent functional outcome at 90 days. Compared with Control, efficacy of RIC in each category and interaction between categories were investigated. (II) To investigate the effect of RIC treatment on SBPV, SBPV parameters were compared between RIC and Control groups. Compared with Control, a higher likelihood of primary outcome in RIC was found in high category (max–min: adjusted risk difference [RD] = 7.2, 95% CI 1.2–13.1, P = 0.02; standard deviation: adjusted RD = 11.5, 95% CI 1.6–21.4, P = 0.02; coefficient of variation: adjusted RD = 11.2, 95% CI 1.4–21.0, P = 0.03). Significant interaction of RIC on outcomes were found between High and Low standard deviations (adjusted P < 0.05). No significant difference in SBPV parameters were found between treatment groups. This is the first report that Chinese patients with acute moderate ischemic stroke and presenting with higher SBPV, who were non-cardioemoblic stroke and not candidates for intravenous thrombolysis or endovascular therapy, would benefit more from RIC with respect to functional outcomes at 90 days, but 2-week RIC treatment has no effect on SBPV during hospital.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association of systolic blood pressure variability with remote ischemic conditioning in acute ischemic stroke

Cui,

Ning,

Cai

et al. 2024

Sci Rep

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Study on the efficacy of compound porcine cerebroside and ganglioside injection in patients with ischemic stroke: A randomized, single‐center, open‐label, prospective study

Chen,

Zhang,

Zhang

et al. 2023

Ibrain

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Compound porcine perebroside and ganglioside injection (CPCGI) was used to treat stroke. The study was initiated because of the high incidence of low‐does CPCGI use in our area. However, no research has confirmed the effectiveness of CPCGI below the standard dose. Therefore, the aim of this study was to provide a reference for the clinical selection of different dose treatments. We collected ischemic stroke patients and divided them into three groups (low‐dose group: Group A = 4 mL, Group B = 6 mL, standard‐dose group: Group C = 10 mL). The modified Rankin Scale (mRS) scores, the National Institutes of Health Stroke Scale (NIHSS) scores, and the Barthel Index (BI) scores were performed before treatment and 14 days and 90 days post CPCGI treatment. For 90 days, the primary outcomes were calculated including the degree of disability, neurological recovery, and activities of daily living. All data were compared between pretherapy and posttreatment and among groups. NIHSS, mRS and BI scores improved on 14 and 90 days in each group. Group B and C improved than Group A on 14 and 90 days. The difference between groups B and C was not statistically significant. On 90 days, there were differences in the degree of disability, the recovery of neurological function, and the ability of daily living among groups. No drug‐related adverse reactions occurred in the groups. Although 4 or 6 mL CPCGI had some neuroprotective effects, the standard dose of 10 mL CPCGI had the best effect on reducing the degree of disability and improving abilities of daily living.

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Relationship of Day-by-Day Blood Pressure Variability and Admission Stroke Severity in Acute Ischemic Stroke

Zhu,

Wu,

Zheng

et al. 2024

The Neurologist

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Objectives: Research on the association between stroke severity and day-by-day blood pressure variability (BPV) in acute ischemic stroke (AIS) is rare as the majority focus on the blood pressure (BP) or the short-term BPV. Our study aims to explore the exact roles of daily BPV through the 7-day commencement on stroke severity in AIS. Methods: The study included 633 patients with AIS, defining AIS as the time from the beginning of symptom up to 7 days with recording BP twice a day as well as calculating the daily BPV, and then matching them to the stroke severity. The logistic regression models were used to evaluate associations between stroke severity and day-by-day BPV. We used the smooth curve fitting to identify whether there was a nonlinear association. In addition, the subgroup analyses were performed using the logistic regression. Results: According to the modified National Institutes of Health Stroke Scale score, 301 (47.5%) patients were allocated to the mild stroke group and 332 (52.5%) to the moderate-to-severe stroke group. In terms of stroke categories, we found no significant difference between BP at admission or mean BP. However, the moderate-to-severe stroke group exhibited higher daily BPV. The multiple logistic regression analysis indicated that day-by-day BPV was positively correlated to stroke severity [odds ratio (OR)=1.05, 95% CI:1.01–1.1, P=0.03 for SBP-SD; OR=1.08, 95% CI:1.01–1.15, P=0.03 for SBP-CV; OR=1.04, 95% CI:1.01–1.07, P=0.015 for SBP-SV). Conclusions: High day-by-day BPV in AIS was associated with more severe stroke independent of BP levels.

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Daily blood pressure variability in relation to neurological functional outcomes after acute ischemic stroke

Cited by 4 publications

References 34 publications

Association of systolic blood pressure variability with remote ischemic conditioning in acute ischemic stroke

Association of systolic blood pressure variability with remote ischemic conditioning in acute ischemic stroke

Study on the efficacy of compound porcine cerebroside and ganglioside injection in patients with ischemic stroke: A randomized, single‐center, open‐label, prospective study

Relationship of Day-by-Day Blood Pressure Variability and Admission Stroke Severity in Acute Ischemic Stroke

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